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近年,患者立脚型のアウトカム評価が推奨されているが,整形外科外来診療における患者満足度の調査報告は見られない.本研究では外来患者において,その症状,期待度ならびに満足度を経時的に調査することを目的とした.まず初診時に受診理由,仕事,臨床症状,期待度,健康状態を測定する包括的尺度(SF-12)を,初診後約3カ月での追跡調査時に治療状況,臨床症状,SF-12,満足度を調査した.対象は外来初診患者1,000名のうち,調査票が完全に回答された594名である.受診理由の第1位は痛み,第2位は「これ以上悪くなると困る」であった.初診時の痛み,日常生活動作・仕事・趣味・スポーツ活動の支障は,VAS(100mm)で平均48~58であった.治療後の症状に対する期待度はVASで平均9~12と,初診時の症状のおよそ5分の1となっていた.追跡調査時に症状はVASで22~28とすべて初診時より有意に改善していたが,期待値よりは症状が強かった.満足度は,期待通りだった:59%,この治療なら受けてもよいと思う:28%と,87%が満足していた.症状→期待→治療成績→満足度を知ることは,運動器医療の問題解決に寄与し得ると考えられる.
The purpose of this study was to determine patients' expectations and assess the level of fulfillment of those expectations. This study was based on a prospective cohort of outpatients of our department. A thousand patients were enrolled into the study. Functional health status, expectations, reasons for consulting, and expected post-treatment status were inquired at the first medical examination and the satisfaction at 3 months after that was investigated. 594 patients completed the questionnaire forming the cohort of this study. There were 313 women and 281 men with a mean age of 45 years. Regarding reasons for consulting, reducing pain was the number one concern, followed by future consequences. Although the mean VAS of functional health status significantly improved (p<0.0001) from 53 to 25, which was higher than patients' expected post-treatment status;the mean VAS of 11. Based on their satisfaction, 87% of the patients chose favorable satisfaction including 59% who chose “treatment met my expectations”. The evaluation of the doctor's skill should be the next issue to be dealt with.
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